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Asthma: General Info

If you are reading this, you might be someone who has asthma. The more you know about asthma, the better you can care for yourself. This guide was created to answer your questions about asthma and help you manage your symptoms.

What is asthma?

Asthma is a chronic condition of the lungs that affects how you feel and breathe. It’s not contagious-you can’t get asthma from someone else (like a cold), and you can’t pass it on to anyone else. You can have symptoms that occur every day, weekly, every few months or hardly at all. Some children seem to outgrow it but most teens with asthma will continue to have symptoms as an adult. Most importantly with the proper treatment, people with asthma can have normal and active lives.

What exactly happens when I have asthma symptoms?

When you have asthma, the airways in your lungs are swollen and inflamed. The airways are the tubes that carry air in and out of your lungs. When you are exposed to something that irritates the airways, they start to narrow, getting smaller with less air able to move in and out. Muscles in and around the swollen airways get tight and more mucous is made. This causes you to have trouble breathing, with chest tightness, coughing, and sometimes “wheezing”, or a whistling sound when you breathe.

What are of the most common symptoms of asthma?

Coughing, especially during the night, early morning, when outside in the cold air or while exercising

Wheezing that can be heard when you breathe

Shortness of breath or trouble breathing

Chest tightness or pain which may feel like someone is sitting on your chest or squeezing it.

If you have any of these symptoms, talk to your health care provider!

Asthma symptoms can range from mild to severe – from being a little annoying to seriously affecting how you are feeling. When symptoms are severe, asthma can be life threatening.

Causes and Triggers

What causes asthma?

No one knows for sure what causes asthma, but doctors have found that certain things in the environment can irritate a person’s breathing and cause symptoms. Asthma runs in families, and teens who are overweight are more likely to have asthma. Most teens who are diagnosed with asthma have allergies that can aggravate their breathing.

What are triggers?

Triggers are things in the environment that bring on asthma symptoms or “asthma flare-ups” (sometimes called asthma attacks). Some triggers such as pollen will only affect people with asthma during certain seasons and not throughout the year. Others may have symptoms only when they are around a cat, for example.

The following categories and list of “triggers” can cause asthma symptoms for some people.

Allergens: things that you are sensitive to that cause a type of allergic reaction

Dust mites

Animal dander – (which is from skin, fur or feathers of animals)

Cockroach and rodent droppings

Pollen from trees, grasses, weeds, and flowers

Mold and mildew

Irritants: (smells and other things that you might inhale (breathe in) through your nose, mouth and into your lungs)

Cigarette smoke – both smoke from your own cigarette or someone else’s

Sports and other physical activities (such as running) that cause sudden and rapid breathing

Viral infections

Colds and flu or other infections of the nose, throat, lungs, etc. that can cause coughing, sore throat, and/or trouble breathing

The thing about triggers is that one type of trigger (let’s say dust mites) may cause your friend’s asthma symptoms, but another kind of trigger (such as dog dander) may bring on your symptoms. Triggers can vary among people. While taking your medicine and avoiding your triggers is the best way to control asthma and prevent symptoms, you can’t always avoid triggers in the environment.

You can, however, be proactive about certain things such as:

If you are allergic to dust, keep your bed and bedroom as dust free as possible. (Carpets, drapes, and stuffed animals collect dust and dust mites-get rid of these items if possible.)

Stay in an air conditioned place if the air quality outside is especially bad (on humid/hot days).

Get a yearly flu shot.

WASH YOUR HANDS often – This is the #1 way to lower your risk of catching colds or the flu.

Try keeping notes about your symptoms. Write down what the weather was like, what you were doing, what time of day it was, etc. when you have asthma symptoms.

Living with Asthma

Will I always have asthma?

Studies have shown that asthma usually does not go away, and that the swelling in your lungs actually stays there even when your asthma is not bothering you. This is important to know because you need to pay attention to how you feel and if your breathing changes.

It’s true that some people only have asthma as a child and never seem to have symptoms again. Others can have symptoms their whole lives. Finally, there are other people who have no symptoms for years and then have it bother them again, many years later. It is important to remember that asthma is a chronic condition, which means it can keep coming back, unlike a common cold which is temporary. As a teen with asthma, you will probably have it as you grow into adulthood.

Remember – Asthma is very treatable and you should be able to live a normal, healthy life, and be as active as you would like. In fact, some teens forget to mention they have asthma (or a history of asthma) to a new health care provider or their school nurse. It is very important to remember to tell your health care provider or someone else involved in your health about your asthma and what medications you are taking even if you have not had any symptoms for a long time. Learn the name and dosage strength of your asthma medications as many medications come in different strengths- it’s not enough to just identify asthma medications by the color of the inhaler! And, ALWAYS use a spacer device when using your inhaler – it guarantees the right amount of medicine getting into your lungs instead of all over your mouth and throat.

If you’re concerned about asthma, here’s a tip on how to bring it up with your health care provider: I sometimes have trouble breathing and catching my breath. Could I have asthma?

Asthma: Diagnosis and Treatment

If I think I have asthma what should I do?

If you haven’t been to your health care provider yet and you think you might have asthma, call and make an appointment as soon as possible. Getting diagnosed and treated quickly will make a big difference in the way you feel.

How is asthma diagnosed?

Only your health care provider can tell if you have asthma. He/she will ask you questions about how you are feeling in general and also specific questions about your breathing. You will be asked about your past health and your family’s health and about any medications you take and if you have any allergies. Your health care provider will likely give you a physical exam and check your nose, listen to your lungs and heart, etc. to make sure you don’t have any other problems. You might be asked to breathe into a tube (called a “peak flow meter”) that measures how much air your lungs can hold. If you are diagnosed with asthma you may be referred to a specialist.

What is exercise-induced asthma (EIA)?

Some people only have asthma symptoms when they exercise or play sports. People with EIA have airways that are overly sensitive to sudden changes in temperature and humidity, especially when breathing colder, drier air during aerobic exercise. There are some things you can do to help control exercise-induced asthma.

Take a quick-acting prescription inhaler 15 minutes before you exercise (to open up your airways)

Do warm up exercises for about 10-minutes before heavy physical activity

Begin exercising slowly and work up to a faster pace-This has been found to prevent asthma symptoms during exercise

If you have symptoms and need your Albuterol more than twice a week, you probably need a medication you can take daily to control your symptoms. This daily controller medication may come as another type of inhaler, or as a pill. SEE YOUR HEALTH CARE PROVIDER IF YOU NEED YOUR DAILY RESCUE MEDICATION (ALBUTEROL) MORE THAN TWICE A WEEK WHEN YOU ARE OTHERWISE FEELING WELL.

If you are having trouble with your asthma while you are exercising, try the following:

IMMEDIATELY STOP any activity you are doing and stay calm. Sometimes just taking a break helps

Get out of the cold temperature and away from dust and dirt particles such as dust from a dry soccer field

Take your quick-relief/Albuterol inhaler (you should always carry one with you if you have asthma!)

Treatment

How is asthma treated?

Asthma is treated by: keeping track of how well your lungs are working (your health care provider will listen to your lungs), taking medications as directed, avoiding things that make it worse (triggers), controlling things in your environment, and learning how to manage it. Although there is currently no cure for asthma, it can be controlled extremely well.

An important part of asthma care is what you do to help manage it. Controlled asthma means you have very few or no symptoms and are able to do what you want to do.

Tips to control your asthma symptoms:

See your health care provider regularly and talk about any concerns you might have

Take medications as prescribed by your health care provider

Use a spacer with all inhaled medication, unless it is a dry powder. (Your health care provider will tell you if your inhaler is a dry powder.)

Use a “peak flow meter” if you have one, especially to check your numbers when you have a cold or flu.

Keep a “symptom diary” that describes time, date, severity (how bad you feel) and exposure activity (what were you doing when the symptoms got worse)

Know your asthma “triggers” and try to avoid or eliminate them

Pay attention to your asthma so you know when it is getting worse and when to get help

Rest if your asthma is bothering you

Don’t smoke, or quit if you do

Learn as much as you can about asthma because the more you know, the better you can help care for yourself and feel good most of the time

You may have times when you don’t take care of your asthma as you usually do, such as forgetting to take your medicine or not remembering what triggers your asthma. Sometimes no matter what you do, your asthma may bother you when you least expect it to and you’ll need to take a fast-acting, quick-relief asthma medicine called Albuterol (that open up your airways so you can breathe easier). If your Albuterol doesn’t make you feel better within 20 minutes, this means there is too much swelling or inflammation in your lungs–you should call your health care provider immediately, or call 911.

What kinds of medicines are used to treat asthma?

Some people need to take one or more types of medication daily for their asthma and others may not need to take any except when their asthma is bothersome. Your health care provider will decide what medications you need to take.

The two main components of asthma are brocho-constriction – tightening of the muscles around your airways, and inflammation or swelling inside your airways.

Albuterol – also known as your “rescue” or “quick reliever” medicine will relax the muscles around your airways. There are 3 brands of Albuterol – ProAir®, Proventil®, and Ventolin®. They all have the same ingredients and work the same way.

Controller medications are medicines that you need to take every day to decrease the swelling in your airways. Controller medications can be inhalers such as Flovent®, Pulmicort®, Asmanex, QVAR®, Alvesco®, Aerospan®, Advair®, Dulera®, Arnuity™, Breo® or Symbicort® or perhaps a pill such as Montelukast or Singulair. Your health care provider will teach you how and when to use your medicine.

Asthma: Action Plan and Getting Help

An asthma action plan is a proactive way to keep your asthma under control. It is written with your health care provider (HCP) and is personalized (just for you) An asthma plan has 3 zones – green, yellow, and red.

The green zone lists what medications you should take when you are feeling well.

The yellow zone tells you what to do at the first sign of a cough, cold, or wheeze.

The red zone tells you what to do if your Albuterol isn’t helping, or if you are very short of breath.

The idea behind having a “plan” is having important information such as: steps you need to take to stay symptom-free, a list of your medicines – the doses and how often you take them, your health care provider’s phone number, and a list of your asthma triggers, so you can have all these facts in one central location. You should have a copy of your Asthma Action Plan at home and with the nurse at school. You can also make a copy of your action plan and keep it with you. An asthma action plan also includes simple and clear instructions about how to identify early symptoms of an “asthma flare-up”, how to treat them, and when to go to the emergency room. You should feel comfortable talking with your HCP about your action plan and update it as things change.

Getting Help

It can be very scary if you have trouble breathing. Having a plan in mind and knowing when to go to the emergency room will help ease your worries.

What are the signs that I need to get help right away?

You are feeling like you need to use your fast acting (Albuterol) inhaler more than once every 4 hours

Your fast acting inhaler (Albuterol) does not start to work within 20 minutes of when you take it.

You are having trouble talking or walking because you are out of breath

You are not able to breathe – call an ambulance and go to the closest emergency room

What should I do in an emergency?

If you have been using your asthma medications and they aren’t working and you can’t breathe – call an ambulance right away! If you don’t feel it’s an “emergency”, contact your health care provider. Remember – many teens have reported feeling like they should have taken an ambulance instead of having a friend or family member take them to the hospital by car, as their breathing got worse during the drive. Whoever is taking you to the hospital will not know what to do if you suddenly can’t breathe – and it CAN happen.

Individual Guides

Young Men’s Health (YMH) is produced by the Division of Adolescent and Young Adult Medicine at Boston Children’s Hospital. The purpose of the website is to provide carefully researched health information to teenage boys and young men.